GRASTON TECHNIQUE By Dymond Unutoa

Objectives Know what Graston technique (GT) is Understand the history of Graston technique Be able to recognize Graston tools and understand the purpose behind each one’s design Understand the purpose of GT and its effects Know contraindications associated with GT Know other forms of Instrument assisted soft tissue mobilization and their basic premise Understand how Graston differs from other IASTM

What is Graston technique? Graston Technique is a form of instrument assisted soft tissue mobilization Utilizes 6 different tools Utilizes stainless steel tools to detect and treat tissue restrictions that affect normal function

History of Graston technique Researched at Ball State University 1991-92 Therapy Care Resources Inc. 1994 15,000+ Clinicians utilize GT 1,400+ Out-Patient clinics 200+ professional and amateur sports organizations Currently part of curriculum at 50+ colleges and universities

The Technique Effects Separates and breaks down collagen cross-links, and splays and stretches connective tissue and muscle fibers Increases skin temperature Facilitates reflex changes in the chronic muscle holding pattern Alters spinal reflux activity (facilitated segment)

Technique Effects cont’d Increases the rate and amount of blood flow to and from the area Increases cellular activity in the region, including fibroblasts and mast cells Increases histamine response secondary to mast cell activity

Some Conditions for GT Utilization Sprains and Strains Carpal Tunnel Syndrome Medial/Lateral Epicondylitis Scar Tissue Development Shin Splints Rotator Cuff Tendinosis Plantar Fasciitis Patellofemoral Disorders Trigger Finger Achilles Tendinosis

Contraindications Absolute Relative Open wound Unhealed fracture site Thrombophlebitis Uncontorolled Hypertension Kidney Dysfunction Hematoma Osteomyelitis Patient intolerance or Hypersensitive Anti-coagulant Medications Cancer Varicose Veins Burn Scars Acute Inflammatory Conditions Inflammation Secondary to Infection RA Pregnancy Osteoporosis

The GT Instruments

Styles of Soft Tissue Mobilization IASTM (Instrument Assisted Soft Tissue Mobilization) – Includes the following… GRASTON ASTM (Augmented Soft Tissue Mobilization) or ASTYM ART (Active Release Technique) SASTM (Sound Assisted Soft Tissue Mobilization) Gua Sha Massage

Common Seen Effects Petechiae Bruising Loss of Pain Increased ROM Restoration of function

Usage of Graston Tools Enhance detection of adhesions, scar tissue or restrictions Clinicians will use the tools to comb over and “catch” on fibrotic tissue to identify restricted area. They will then use the tools to break up the scar tissue for reabsorption

Why Stainless Steel The stainless steel of Graston tools act somewhat like a tuning fork when fibrotic tissue is contacted. A resonance or reverberation within the instrument is created on contact and transmits through the instrument to the clinician’s hands

So Who Uses GT? Available to the following licensed professionals: Physical Therapist/Physiotherapist Occupational Therapist Chiropractor Certified Athletic Trainer Medical Physician Dentist Osteopath Podiatrist Selected Canadian Registered Massage Therapists *PTA/OTAs are eligible for training when working under a GT-trained PT or OT.

ASTM or ASTYM

SASTM

Gua Sha

Other Article Related Information Sensitivity: GT was found not to be effective in pressure pain threshold In Quadriceps testing, GT resulted in decreased muscle activation, yet increased force production

Graston in Action

References Hammer WI. The effect of mechanical load on degenerated soft tissue. J Bodyw Mov Ther. 2008 Jul; 12(3):246–56. Hammer WI, Pfefer MT. Treatment of a case of subacute lumbar compartment syndrome using the Graston technique. J Manipulative Physiol Ther. 2005 Mar–Apr; 28(3):199–204. Howitt S, Wong J, Zabukovec S. The conservative treatment of Trigger thumb using Graston Techniques and Active Release Techniques. J Can Chiropr Assoc. 2006 Dec; 50(4):249–54. Howitt S, Jung S, Hammonds N. Conservative treatment of a tibialis posterior strain in a novice triathlete: a case report. J Can Chiropr Assoc. 2009 Mar; 53(1):23–31. Black DW. Treatment of knee arthrofibrosis and quadriceps insufficiency after patellar tendon repair: a case report including use of the graston technique. Int J Ther Massage Bodywork. 2010 Jun 23; 3(2):14–21